Confidence in beliefs about pain predicts expectancy effects on pain perception and anticipatory processing in right anterior insula.

Psychological factors play a major role in exacerbating chronic pain. Effective self-management of pain is often hindered by inaccurate beliefs about the nature of pain which lead to a high degree of emotional reactivity. Probabilistic models of perception state that greater confidence (certainty) in beliefs increases their influence on perception and behavior. In this study, we treat confidence as a metacognitive process dissociable from the content of belief. We hypothesized that confidence is associated with anticipatory activation of areas of the pain matrix involved with top-down modulation of pain. Healthy volunteers rated their beliefs about the emotional distress that experimental pain would cause, and separately rated their level of confidence in this belief. Confidence predicted the influence of anticipation cues on experienced pain. We measured brain activity during anticipation of pain using high-density EEG and used electromagnetic tomography to determine neural substrates of this effect. Confidence correlated with activity in right anterior insula, posterior midcingulate and inferior parietal cortices during the anticipation of pain. Activity in the right anterior insula predicted a greater influence of anticipation cues on pain perception, whereas activity in right inferior parietal cortex predicted a decreased influence of anticipatory cues. The results support probabilistic models of pain perception and suggest that confidence in beliefs is an important determinant of expectancy effects on pain perception.

Longitudinal prediction of the operational energy use of buildings

Thus far most studies of operational energy use of buildings fail to take a longitudinal view, or in other words, do not take into account how operational energy use changes during the lifetime of a building. However, such a view is important when predicting the impact of climate change, or for long term energy accounting purposes. This article presents an approach to deliver a longitudinal prediction of operational energy use. The work is based on the review of deterioration in thermal performance, building maintenance effects, and future climate change. The key issues are to estimate the service life expectancy and thermal performance degradation of building components while building maintenance and changing weather conditions are considered at the same time. Two examples are presented to demonstrate the application of the deterministic and stochastic approaches, respectively. The work concludes that longitudinal prediction of operational energy use is feasible, but the prediction will depend largely on the availability of extensive and reliable monitoring data. This premise is not met in most current buildings. © 2011 Elsevier Ltd.